ABSTRACT
Linking records of the same person from different sources makes it possible to build administrative cohorts and perform longitudinal analyzes, as an alternative to traditional cohort studies, and have important practical implications in producing knowledge in public health. We implemented the Fellegi-Sunter probabilistic linkage method to a sample of records from the Mexican Automated System for Hospital Discharges and the Statistical and Epidemiological System for Deaths and evaluated its performance. The records in each source were randomly divided into a training sample (25%) and a validation sample (75%). We evaluated different types of blocking in terms of complexity reduction and pairs completeness, and record linkage in terms of sensitivity and positive predictive value. In the validation sample, a blocking scheme based on trigrams of the full name achieved 95.76% pairs completeness and 99.9996% complexity reduction. After pairs classification, we achieved a sensitivity of 90.72% and a positive predictive value of 97.10% in the validation sample. Both values were about one percentage point higher than that obtained in the automatic classification without clerical review of potential pairs. We concluded that the linkage algorithm achieved a good performance in terms of sensitivity and positive predictive value and can be used to build administrative cohorts for the epidemiological analysis of populations with records in health information systems.
ABSTRACT
Resumen: ANTECEDENTES Existen antecedentes de que el control estricto de las cifras de presión arterial puede repercutir favorablemente evitando la aparición de microalbuminuria y, por tanto, previniendo la nefropatía, asimismo, disminuye significativamente los desenlaces fatales por enfermedad cardiovascular y cerebrovascular. OBJETIVO Demostrar que el control estricto de las cifras tensionales puede disminuir la microalbuminuria. MATERIAL Y METODO Estudio observacional y descriptivo efectuado de enero a diciembre de 2017, en el que se evaluaron pacientes con diagnóstico establecido de diabetes mellitus tipo 2, hipertensión arterial sistémica o ambas; la selección fue aleatoria. A estos pacientes se les incorporó en un protocolo de automedición a préstamo de la presión arterial. No se incluyeron pacientes con insuficiencia renal crónica. RESULTADOS Se incluyeron 200 pacientes en quienes se midió la correlación entre múltiples variables y la existencia de microalbuminuria. Se encontró correlación estadísticamente significativa al segmentar a los pacientes según la clasificación de ACC/AHA 2017 y posterior al ajuste de la dosis de antihipertensivo con valor de p = 0.00001. CONCLUSIONES Con estos hallazgos podría plantearse el ajuste del tratamiento con base en las cifras tensionales del paciente, sin importar si el tratamiento es con IECAS o ARA II.
Abstract: BACKGROUND There are precedents that the strict control of the blood pressure figures can have a favorable impact avoiding the development of microalbuminuria, and therefore preventing the appearance of nephropathy, as well as significantly reducing fatal outcomes due to cardiovascular and cerebrovascular disease. OBJECTIVE To show that strict control of tension figures can impact decreasing the microalbuminuria. MATERIAL AND METHOD An observational and descriptive study was done from January to December 2017 with patients with an established diagnosis of type 2 diabetes mellitus and/or systemic hypertension, with random selection. These patients were incorporated into a Self-Commissioning Protocol to loan blood pressure. Patients with chronic kidney disease were not included. RESULTS There were included 200 patients. The correlation between multiple variables and the presence of microalbuminuria was measured finding a statistically significant correlation when segmenting patients according to the ACC/AHA 2017 classification and after adjusting the antihypertensive dose with p = 0.00001. CONCLUSIONS Treatment should be adjusted based on the patient's blood pressure, regardless of whether the treatment is with IECAS or ARA II.
ABSTRACT
Transnationalism explores social, economic and political processes that occur beyond national borders and has been widely used in migration studies. We conducted a systematic review to explore if and how transnationalism has been used to study migrants' health and what a transnational perspective contributes to understanding health practices and behaviors of transnational migrants. We identified 26 empirical studies published in peer-reviewed journals that included a transnational perspective to study migrants' health practices and behaviors. The studies describe the ways in which migrants travel back and forth between countries of destination to countries of origin to receive health care, for reasons related to cost, language, and perceptions of service quality. In addition, the use of services in countries of origin is related to processes of social class transformation and reclaiming of social rights. For those migrants who cannot travel, active participation in transnational networks is a crucial way to remotely access services through phone or email, and to acquire medical supplies and other health-related goods (traditional medicine, home remedies). We conclude with recommendations for future research in this area.
Subject(s)
Health Behavior/ethnology , Internationality , Transients and Migrants/psychology , HumansABSTRACT
The pharmaceutical industry generates wastewater discharges of varying characteristics and contaminant concentrations depending on the nature of the production process. The main chemicals present in these effluents are solvents, detergents, disinfectants - such as sodium hypochlorite (NaClO) - and pharmaceutical products, all of which are potentially ecotoxic. Therefore, this study aimed to evaluate the geno- and cytotoxicity induced in the common carp Cyprinus carpio by the effluent emanating from a nonsteroidal anti-inflammatory drug (NSAID)-manufacturing plant. Carp were exposed to the lowest observed adverse effect level (LOAEL, 0.1173%) for 12, 24, 48, 72 and 96 h, and biomarkers of genotoxicity (comet assay and micronucleus test) and cytotoxicity (caspase-3 activity and TUNEL assay) were evaluated. A significant increase with respect to the control group (p<0.05) occurred with all biomarkers from 24h on. Significant positive correlations were found between NSAID concentrations and biomarkers of geno- and cytotoxicity, as well as among geno- and cytotoxicity biomarkers. In conclusion, exposure to this industrial effluent induces geno- and cytotoxicity in blood of C. carpio.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal , Wastewater/toxicity , Water Pollutants, Chemical/toxicity , Animals , Biomarkers , Carps , Comet Assay , DNA Damage , Disinfectants/toxicity , Drug Industry , Micronucleus Tests , Sodium Hypochlorite/toxicity , Wastewater/chemistryABSTRACT
Many toxic xenobiotics that enter the aquatic environment exert their effects through redox cycling. Oxidative stress, which incorporates both oxidative damage and antioxidant defenses, is a common effect induced in organisms exposed to xenobiotics in their environment. The results of the present study aimed to determine the oxidative stress induced in the common carp Cyprinus carpio by contaminants [metals and nonsteroidal anti-inflammatory drugs (NSAIDs)] present in Madín Reservoir. Five sampling stations (SSs), considered to have the most problems due to discharges, were selected. Carp were exposed to water from each SS for 96 h, and the following biomarkers were evaluated in gill, blood, and muscle: hydroperoxide content, lipid peroxidation, protein carbonyl content, and the activity of antioxidant enzymes superoxide dismutase and catalase. Results show that contaminants (metals and NSAIDs) present in water from the different SSs induce oxidative stress. Thus, water in this reservoir is contaminated with xenobiotics that are hazardous to C. carpio, a species consumed by the local human population.